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Step 2 CK > Rapid Review > Flashcards

Rapid Review Flashcards

1
Q

Pulsus paradoxicus

A

Drop in SBP > 10 mmHg with inspiration

Seen in cardiac tamponade, COPD/severe asthma

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2
Q

8 surgically correctable causes of secondary hypertension

A 
Renal artery stenosis 
Coarctation of the aorta
Pheochromocytoma 
Conn's syndrome 
Cushing's syndrome 
Unilateral renal parenchymal disease
Hyperthyroidism 
Hyperparathyroidism
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3
Q

Treatment of ACS

A 
ASA 
Heparin 
Clopidogrel 
Morphine (+ SL nitro as second line agent for pain) 
IV B-blockers
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4
Q

Metabolic syndrome

A

3/5 criteria must be met:

Abdominal obesity (>40” for men or >35” for women)
High triglycerides > 150mg/dL
Low HDL 130/85 or on anti-HTN meds
Insulin resistance with fasting glucose > 100

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5
Q

Most common cause of HTN in young men and women

A

Men - excessive EtOH

Women - OCPs

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6
Q

Figure 3 sign

A

Aortic coarctation

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7
Q

Water-bottle shaped heart

A

Pericardial effusion

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8
Q

Lichen planus

A

Violaceous, polygonal, flat-topped papules - initial lesions often appear on genitals and are intensely pruritic; may be associated with HCV

Treat with topical corticosteroids (mild cases) or systemic corticosteroids + phototherapy (severe cases)

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9
Q

Tinea versicolor - Microscopy and Treatment

A

KOH prep has a “spaghetti-and-meatballs” appearance. May be noticed after sun exposure because lesions appear hypopigmented in contrast to tan skin.

Treat with ketoconazole or selenium sulfide

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10
Q

Seborrheic dermatitis - treatment

A

Selenium sulfide or zinc pyrithione shampoo

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11
Q

First line treatment for pheochromocytoma

A

alpha-blockers (phentolamine, phenoxybenzamine) first, THEN beta blockers

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12
Q

A test that consistently gives identical (incorrect) results is:

A

Highly reliable (precise) with low validity (accuracy)

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13
Q

Odds ratio

A

In cohort studies, the odds of developing the disease in the exposed group / the odds of developing the disease in the unexposed group

In case-control sudies, the odds that the cases were exposed divided by the odds that the controls were exposed

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14
Q

Rare disease hypothesis

A

OR approximates RR when disease prevalence is low

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15
Q

Relative Risk

A

Cohort studies - incidence in the exposed group divided by incidence in the unexposed group

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16
Q

In which patient groups do you initiate colorectal cancer screening early?

A

Patients with IBD
Patients with FAP / HNPCC
Patients who have first degree relatives with adenomatous polyps

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17
Q

Most common cancer in men

A

Prostate

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18
Q

Most common cause of cancer death in men

A

Lung

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19
Q

Standard deviation

A

Percent of cases within 1 SD of the mean = 67%
Percent of cases within 2 SD of the mean = 95%
Percent of cases within 3 SD of the mean = 99.7%

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20
Q

Conditions in which confidentiality must be overridden

A

Real threat of harm to third parties
Suicidal intentions
Certain contagious (reportable) diseases
Elder and child abuse

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21
Q

Rationale for involuntary commitment / isolation for medical treatment

A

When treatment noncompliance represents a serious danger to public health (i.e. active TB)

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22
Q

Diagnostic modality used when US is equivocal for cholecystitis

A

HIDA scan

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23
Q

Most common cause of small bowel obstruction in patients with no hx of abdominal surgery

A

Incarcerated hernia

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24
Q

Diarrheal organism - most common

A

Campylobacter

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25
Q

Diarrheal organism - camping

A

Giardia

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26
Q

Diarrheal organism - travel

A

ETEC

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27
Q

Diarrheal organism - church picnic with mayonnaisse

A

S. aureus pre-formed toxin (vomiting is more common than diarrhea)

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28
Q

Diarrheal organism - uncooked hamburgers

A

EHEC

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29
Q

Diarrheal organism - Fried rice

A

Bacillus cereus

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30
Q

Diarrheal organism - Poultry/eggs

A

Salmonella

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31
Q

Diarrheal organism - raw seafood

A

Vibrio cholera, HAV

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32
Q

Diarrheal organisms (3) - AIDS

A

Cryptosporidium
Isospora
MAC

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33
Q

Diarrheal organism - Pseudoappendicitis

A

Yersinia

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34
Q

Extra-intestinal manifestations of IBD

A 
Uveitis 
Ankylosing spondylitis 
Pyoderma gangrenosum 
Erythema nodosum 
Primary sclerosing cholangitis
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35
Q

Medical treatment for IBD

A

5-ASA + steroids during acute exacerbations

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36
Q

Reynold’s pentad

A

Charcot’s triad (fever, jaundice, RUQ pain) + shock and hypotension - signs of ascending cholangitis

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37
Q

Medical treatment of hepatic encephalopathy

A

Decrease protein intake, lactulose, Rifamixin

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38
Q

Oliguria, petechiae, and jaundice following an illness with bloody diarrhea - diagnosis?

A

Hemolytic uremic syndrome due to EHEC

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39
Q

Causes of drug-induced hepatitis

A

TB meds (isoniazid, rifampin, pyrazinamide)
Acetaminophen
Tetracycline

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40
Q

Hernia with highest risk of incarceration

A

Femoral

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41
Q

Precipitans of hemolytic crisis in patients with G6PD deficiency

A

Sulfonamides
Malaria drugs
Fava beans

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42
Q

Pure RBC aplasia associated with webbed neck, cleft lip, shield chest, and tri-phalangeal thumbs

A

Diamond-Blackfan anemia

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43
Q

Anemia associated with absent thumbs, diffuse hyperpigmentation and cafe au lait spots, microcephaly, and pancytopenia

A

Fanconi’s Anemia

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44
Q

Thrombotic thrombocytopenic purpura (TTP) pentad

A 
Fever
Anemia 
Thrombocytopenia 
Renal dysfunction 
Neurologic abnormalities
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45
Q

Treatment for TTP

A

PLEX, corticosteroids, anti-platelet drugs

Platelet transfusion is contraindicated

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46
Q

A 14 year old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or elevated PTT, and elevated bleeding time - diagnosis and treatment?

A

von Willebrand’s disease

Treat with desmopressin, FFP, or cryoprecipitate

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47
Q

A 10 year old boy presents with fever, weight loss, and night sweats; examination reveals an anterior mediastinal mass - diagnosis?

A

Non-hodgkin lymphoma

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48
Q

Heinz bodies

A

Intracellular inclusions seen in thalassemia, G6PD deficiency, and post-splenectomy

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49
Q

3 most common causes of fever of unknown origin

A

Infection
Cancer
Autoimmune disease

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50
Q

A patient from Arizona or California presents with fever, malaise, cough, and night sweats - diagnosis and treatment?

A

Coccioidomycosis - treat with Amphotericin B

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51
Q

Meningitis in neonates - causes and treatment?

A

GBS
El Coli
Listeria

Treat with Gentamicin + Ampicillin

52
Q

Meningitis in infants - causes and treatment?

A

Pneymococcus, meningocuccus, H.flu

Treat with cefotaxime and vancomycin

53
Q

Pruritic papule + regional lymphadenopathy that evolves into a black exchar - diagnosis and treatment?

A

Cutaneous anthrax - treat with Penicillin or Ciprofloxacin

54
Q

Characteristics of secondary Lyme disease

A

Migratory arthralgias
Bell’s palsy
Myocarditis

55
Q

Neutropenic nadir post-chemotherapy

A

7-10 days

56
Q

Ring-enhancing brain lesion on CT with seizures

A

Taenia solium (neurocysticercosis)

57
Q

Gram positive aneaerobic branching rods commonly found in oral infections

A

Actinomyces - treat with Penicillin

58
Q

Weakly gram positive, partially acid-fast aerobic filamentous bacteria

A

Nocardia - treat with TMP-SMX

59
Q

Raw pork and skeletal muscle cysts - organism?

A

Trichinella spiralis (pig tapeworm)

60
Q

Sheepherders with liver cysts - organism?

A

Echinococcus (dog tapeworm)

61
Q

Perianal itching - organism?

A

Enterobius vermicularis (pinworm)

62
Q

Meningitis in:
Adults
Elderly
AIDS

A

N. meningidites
S. pneumo
Cryptococcus

63
Q

Alcoholic with pneumonia and/or “currant jelly” sputum

A

Klebsiella

64
Q

Infection in burn victims

A

Pseudomonas

65
Q

Osteomyelitis from a foot puncture wound

A

Pseudomonas

66
Q

Cough and flu-like symptoms, gram stain showing no organisms, silver stain of sputum shows gram negative rods - organism?

A

Legionella

67
Q

Endocarditis in patients with prosthetic heart valves - 2 organisms?

A

S. aureus

S. epidermidis

68
Q

Endocarditis in a native valve after dental work - organism?

A

Streptococcus viridans

69
Q

Reactive arthritis - organisms?

A

Chlamydia is most common; also consider Campylobacter, Shigella, Salmonella, and Ureaplasma

70
Q

Bones commonly fractured by FOOSH

A

Distal radius (Colles fracture), Scaphoid

71
Q

Broca’s aphasia - what lobe and vascular distribution?

A

Frontal lobe, left MCA distribution

72
Q

CSF findings in SAH

A

Elevated ICP, RBCs, xanthochromia

73
Q

Albuminocytologic dissociation

A

Guillian-Barre syndrome (increased protein in CSF without increased cell count)

74
Q

Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathologic?

A

Normal

75
Q

Warm water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the ipsilateral ear. Normal or pathologic?

A

Normal.

76
Q

Treatment for Guillain-Barre syndrome

A

IVIG or PLEX. Avoid steroids.

77
Q

A 6-year old girl presents with a port-wine stain in the V1 distribution as well as with mental retardation, seizures, and ipsilateral leptomeningeal angioma.

A

Sturge-Webeter syndrome

78
Q

Hyperphagia, hypersexuality, hyperorality, and hyperdocility

A

Kluver-Bucy syndrome

79
Q

Chromosomal pattern of complete mole

A

46, XX

80
Q

Antibiotics with teratogenic effects

A

Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides

81
Q

Antibiotics for GBC prophylaxis

A

IV PCN or Ampicillin

82
Q

Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C

A

Asherman syndrome

83
Q

Indications for medical management of ectopic pregnancy

A

Patient stable with an unruptured ectopic pregnancy of

84
Q

A patient presents with recent PID and RUQ pain

A

Fitz-Hugh-Curtis syndrome

85
Q

Annual screening for women with a strong family history of ovarian cancer

A

CA-125 and ultrasound

86
Q

Two consecutive findings of ASCUS on pap - follow up?

A

Colposcopy and endocervical curettage

87
Q

Nontender abdominal mass associated with elevated VMA and HVA in a child; may cross midline

A

Neuroblastoma

88
Q

Bilious emesis within hours after the first feeding

A

Duodenal atresia

89
Q

Most common primary immunodeficiency

A

Selective IgA deficiency

90
Q

Treatment of Kawasaki disease

A

High-dose ASA for inflammation and fever; IVIG to prevent coronary artery aneurysms

91
Q

Sudden onset of mental status changes, emesis, and liver dysfunction after ASA intake

A

Reye Syndrome

92
Q

Which other cancer is associated with retinoblastoma?

A

Osteosarcoma

93
Q

A newborn girl with a posterior neck mass (cystic hygroma) and swelling of the hands (lymphedema)

A

Turner syndrome

94
Q

Key side effects of atypical antipsychotics

A

Weight gain, Type 2 DM, QT prolongation

95
Q

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways - diagnosis and treatment?

A

Acute dystonia (oculogyric crisis) - treat with benztropine or diphenhydramine

96
Q

A 5-month old girl has decreased head growth, truncal discoordination, and decreased social interaction along with loss of developmental milestones

A

Rett disorder

97
Q

Causes of exudative effusions

A

Bacterial or viral infection, malignancy, TB, PE with infarct, pancreatitis

98
Q

Normalizing (increasing) PaCO2 in a patient with asthma exacerbation may indicate what? Treatment?

A

Respiratory muscle fatigue and impending respiratory failure. Intubate !

99
Q

Honeycomb pattern on CXR - diagnosis and treatment?

A

Diffuse interstitial pulmonary fibrosis. Supportive care +/- steroids

100
Q

Acid-base disorder in PE

A

Respiratory alkalosis with hypoxia and hypocarbia

101
Q

Characteristics favoring malignancy in an isolated pulmonary nodule

A

Age > 45-50
Lesions new or larger in comparison to old films
Absence of calficification or irregular calcification
Size > 2cm
Irregular margins

102
Q

Sequelae of asbestos exposure

A

Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass within the lung fields), mesothelioma (pleural mass)

103
Q

Increased risk of what infection with silicosis?

A

TB

104
Q

RTA associated with aldosterone defect

A

Type IV (distal) RTA

105
Q

The most common causes of hypercalcemia

A

Malignancy and hyperparathyroidism

106
Q

T-wave flattening an U-waves

A

Hypokalemia

107
Q

Peaked T waves and widened QRS

A

Hyperkalemia

108
Q

First-line treatment for moderate hypercalcemia

A

IV hydration and loop diuretics

109
Q

Brain anomaly associated with adult autosomal dominant PCKD

A

Cerebral berry aneurysm

110
Q

The most common form of nephrotic syndrome

A

Membranous glomerulonephritis

111
Q

The most common form of nephritic syndrome

A

IgA nephropathy (Berger’s disease)

112
Q

Glomerulonephritis with deafness

A

Alport’s syndrome

113
Q

Glomerulonephritis with hemoptysis

A

Wegener’s granulomatosis and Goodpasture’s Syndrome

114
Q

Waxy casts

A

Nephrotic syndrome

115
Q

Treatment of SIADH

A

Fluid restriction, demeclocycline

116
Q

Hematuria, flank pain, and a palpable flank mass

A

Renal cell carcinoma

117
Q

Testicular cancer associated with b-hcg, AFP

A

Choriocarcinoma

118
Q

The most common type of testicular cancer

A

Seminoma (type of germ cell tumor)

119
Q

Acid-base disorder commonly seen in pregnant women

A

Respiratory alkalosis

120
Q

Three systemic diseases that lead to nephrotic syndrome

A

DM
SLE
Amyloidosis

121
Q

Elevated EPO level, elevated hematocrit, and normal O2 saturation suggest?

A

RCC - evaluate with CT scan

122
Q

Treatment for malignant hypertension

A

Nitroprusside

123
Q

A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal but carboxyhemoglobin is elevated - diagnosis and treatment?

A

CO poisoning - treat with 100% O2 or with hyperbaric O2 if poisoning is severe or the patient is pregnant

124
Q

Radiographic evidence of aortic disruption

A

Widened mediastinum (>8cm)
Loss of aortic knob
Tracheal deviation to the right
Depression of left mainstem bronchus

125
Q

Method of calculating fluid repletion in burn patients

A

Parkland formula: 24-hour fluids = 4 x kg x %BSA

126
Q

Acceptable UOP in a trauma patient

A

50cc/hour

127
Q

Acceptable UOP in a stable patient

A

30cc/hour

Step 2 CK (1 decks)

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